The Clinical Research About Negative Pressure Wound Therapy With Irrigation Of Mupirocin Solution To Promote The Effects In Wound Repair

Purpose: Based on the improvement of closed negative pressure drainage, and the treatment combining mupirocin solution with vacuum sealing drainage technique, the thesis aims to study the effects that the combination has on wound repair.Methods: In the process of study, strict inclusion criteria is made and 46 cases of patients, who suffers trauma, burn and scald infections and other serious skin defect of limbs and trunk, are collected. In addition, the area of the wound, with skin full-thickness defects, more necrotic tissue and, less granulation tissue, is not less than 5*5cm, which can only be healed by skin grafting method or skin flap to repair the wound. Those cases are selected from our hospital from June 2013 to December 2014, which are divided into three groups randomly, namely, the combined group, simple negative pressure group, mupirocin group. The combined group is flushed with mupirocin solution by negative pressure device. The Simple negative pressure group is only treated by vacuum suction, while the mupirocin group undergoes conventional dressing and the use of mupirocin solution in treating wounds. We faithfully record the patients wounds gross changes, area change, wound to the operation conditions of the time, the residual rate of wound tissue necrosis tissue, the bacterial clearance rate, phase II operation for the first time, skin grafting or flap survival rate, wound fresh granulation tissue for HE microscope observation and immunohistochemical observation based on CD34 marker microvascular density(MVD), pipe blockage and other complications, and part of the observation index was analyzed by SPSS software.Results: 1. The negative pressure therapy combined with mupirocin solution washing group(combined group) was better than the simple negative pressure therapy group and the mupirocin therapy group in the growth of granulation tissue after 7 days’ treatment. Three groups are respectively observed under light microscope 7 days before and after the wound granulation tissue in HE staining. Compared with the simple negative pressure therapy group and the mupirocin group, the showed inflammatory cell infiltration degree of the combination group is lower, and active angiogenesis and fibroblast proliferation, collagen fibers in extracellular matrix are rich and regular.2. After 7 days’ treatment, by comparing the three groups’ necrotic tissue and granulation tissue covering the area changes, the necrotic tissue residue rate of the combined group is lower than that of the negative group and the mupirocin group. The differences was statistically significant(p<0.01). In 7 days, compared with the other two groups, the wound tissue neovascularization of the combined group is significantly, higher than that of the simple negative pressure group and the mupirocin group by using CD34 labeled MVD value. The difference was statistically significant(p<0.05).3. There exist differences between the lengths of time which the three groups reached the operation conditions in the wound, namely, "clean the wound". The combined group is shorter than the simple negative pressure therapy group and the mupirocin group, and the difference was statistically significant(p<0.05). Through the comparison of the three groups before and after treatment by counting bacterial culture of wound tissue, the joint group of bacterial clearance rate is higher than that of the simple negative pressure group and mupirocin group, and the difference was statistically significant(p<0.05).4. There are differences in the first skin wound and flap transplantation survival rate between three groups of wound after 7 days’ treatment. The combined group is higher than that of the simple negative pressure group and the mupirocin group, and the difference is statistically significant(p<0.05). At the same time, in contrast with the simple negative pressure, the occurrence of plugging the incidence rate is lower in the joint group, and the difference is statistically significant(p<0.05).Conclusion: 1. Compared with the simple negative pressure therapy and the mupirocin solution dressing treatment, the negative pressure wound therapy combined with mupirocin rinse solution can shorten the operation time to wound conditions for use, have better control over wound infection, and decrease the occurrence of negative pressure wound therapy complications.2. The negative pressure wound therapy combined with mupirocin rinse solution can reduce the necrosis tissue residue rate, better promote the growth and micro vascular wound granulation tissue hyperplasia, improve wound, improve the first phase II wound skin grafting or flap survival rate, which is more conducive to the late wound repair.